Predictive Value Of Serum Uric Acid To Albumin Ratio For In-hospital Adverse Events After Percutaneous Coronary Intervention For ST-segment Elevation Myocardial Infarction

Objective:Many studies have shown that serum uric acid(UA)and serum albumin concentration(SA)are associated with poor prognosis of ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),but there are some controversies.The aim of this study is to investigate whether the uric acid/albumin ratio(UAR)is a better composite parameter for predicting the risk of inhospital MACE in STEMI patients after PCI.Methods:A total of 637 patients who were diagnosed with STEMI and received PCI in Jiangxi Provincial People’s Hospital from February 2016 to August 2021 were reviewed.According to the presence or absence of MACE events,they were divided into the experimental group with MACE events(n=160)and the control group without MACE events(n=553).The baseline clinical data and the incidence of MACE events of the two groups were statistically analyzed.Univariate binary logistic regression analysis was used for statistically significant variables(age,heart rate,white blood cell,hemoglobin,alanine aminotransferase,aspartate aminotransferase,creatinine,albumin,UAR,uric acid),and it was found that these indicators were statistically significant(P < 0.05).UAR was significantly associated with MACE in STEMI patients after PCI(p < 0.001).The area under the ROC curve(AUC)value of UAR was larger and the predictive ability was better.The results of multivariate logistic regression analysis showed that UAR was an independent risk factor for MACE,and other meaningful indicators were included in the modeling.After modeling,the ROC curve AUC=0.63,which showed good prediction performance.UAR had the highest adjusted OR value,indicating that for each unit increase in UAR,the risk of in-hospital MACE in STEMI patients undergoing PCI increased by1.627 times,which was higher than the OR value of other independent risk factors,highlighting its predictive value.According to the best cut-off value(UAR=9.72),673 patients were divided into two groups.UAR > 9.72 was the high-risk group,and UAR < 9.72 was the low-risk group.Logistic regression analysis between the two groups showed that the high-risk group had a higher risk of MACE than the low-risk group.The results suggest that UAR may be an independent risk factor for MACE in STEMI patients after PCI,and it is positively correlated with the occurrence of MACE.Result:(1)The clinical data of the experimental group and the control group were analyzed for the occurrence of MACE.The results showed that the difference in age,white blood cell count,alanine aminotransferase,aspartate aminotransferase,creatinine,uric acid,albumin,UAR value,heart rate and hemoglobin were significant-ly correlated with the occurrence of MACE between the two groups(p < 0.001).(2)Univariate ROC curve analysis showed that except for hemoglobin,the other indicators had predictive value(p < 0.05),among which the area under the ROC curve(AUC)value of UAR was larger(AUC:0.627,sensitivity: 0.633,specificity:0.57),and the predictive ability was better.(3)Univariate Logistic regression analysis showed that age,heart rate,white blood cell,hemoglobin,alanine aminotransferase,aspartate aminotransferase,creatinine,albumin,uric acid,and UAR may be the predictors of MACE(P < 0.05).After the above indicators were modeled using Logistic,the ROC curve was used to score the model value,and the AUC was 0.63,indicating that the accuracy of the prediction model was good,that is,the model had certain value in predicting the occurrence of MACE.(4)After adjusting for confounding factors,multivariate logistic regression analysis showed that age,heart rate,white blood cell count,aspartate aminotransferas-e and UAR were independent risk factors for MACE.UAR had the highest adjusted OR value(OR=1.627),indicating that for each unit increase in UAR,the risk of inhospital MACE in STEMI patients undergoing PCI increased by 1.627 times,which was higher than the OR value of other independent risk factors,highlighting its predictive value.(5)Logistic regression analysis showed that the risk of MACE in the high-risk group(OR:0.468)was higher than that in the low-risk group(OR: 0.208).Conclusion:UAR in STEMI patients may be an independent predictor of MACE after PCI.In addition,the AUC value of UAR was greater than that of its individual components used alone in predicting MACE.As with other prognostic factors for MACE,assessment of this parameter could improve risk classification and personalized treatment and follow-up in STEMI patient populations.